Provider Demographics
NPI:1629307400
Name:JACOB J. FREIMAN, M.D., P.A.
Entity Type:Organization
Organization Name:JACOB J. FREIMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-624-7472
Mailing Address - Street 1:600 HERITAGE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3097
Mailing Address - Country:US
Mailing Address - Phone:561-624-7472
Mailing Address - Fax:561-627-3006
Practice Address - Street 1:600 HERITAGE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3097
Practice Address - Country:US
Practice Address - Phone:561-624-7472
Practice Address - Fax:561-627-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102509261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service